Caputo Mathew P, Aziz Steven, Mifsud Matthew
Otolaryngology-Head and Neck Surgery, University of South Florida Morsani College of Medicine, Tampa, USA.
Cureus. 2021 Apr 7;13(4):e14345. doi: 10.7759/cureus.14345.
Tracheostomies are often utilized in critically ill patients on prolonged mechanical ventilation, to enhance respiratory function and facilitate ventilator weaning. Many coronavirus disease 2019 (COVID-19) patients develop serious respiratory illness requiring ventilator management. In the early phase of this pandemic, the risk of disease spread lead to the development of conservative guidelines which advocated delaying tracheostomy at least two to three weeks from intubation and, preferably, with negative COVID-19 testing. The morbidly obese patient population, however, presents a unique scenario in which early tracheostomy may be beneficial. In this article, we discuss our institution's current practices along with clinical outcomes with reference to intensive care literature and propose that early tracheotomy in COVID-19 patients should be considered on a case by case basis.
气管切开术常用于长期机械通气的重症患者，以增强呼吸功能并促进呼吸机撤机。许多2019冠状病毒病（COVID-19）患者会出现严重的呼吸道疾病，需要进行呼吸机管理。在这场大流行的早期，疾病传播的风险导致了保守指南的制定，该指南主张在插管后至少两到三周延迟气管切开术，最好是在COVID-19检测呈阴性时进行。然而，病态肥胖患者群体呈现出一种独特的情况，早期气管切开术可能有益。在本文中，我们结合重症监护文献讨论了我们机构目前的做法以及临床结果，并建议应根据具体情况考虑对COVID-19患者进行早期气管切开术。
